| NPI | 1336186667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06685700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2020-04124) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2025-04-01 |